1. Speech Acoustics Audiologic Rehabilitation for Children
SPA 6581 – Spring 2015
Lecture Date: 02/09/2015

2. Speech Acoustics Helpful in the following:
Can be used to determine and counsel regarding expectations
“Is it a programming thing or a patient thing?”
Maximize whatever auditory stimulation in order to enhance stimulation of auditory pathways
Knowledge of speech acoustics helps us:
Bridge the disciplines of audiology and habilitation
Judge what speech information is available to a child through their “aided” hearing
Teach parents what the child can do or has the potential to do with his/her aided hearing
Select strategies to facilitate the processing of spoken language through audition
Choose which phonemes can be learned through audition alone, and which may require different strategies (visual or tactile)

3. Collaboration
A speech-language pathologist or educator may report the following:
Specific phonemes missed
Suprasegmentals missed
Quality of speech
Identifying vs. detection of sounds
Level of consistency with responses
Working with other professionals can really help you help yourself!

4. Assessment
It is important to constantly evaluate performance with regards to speech perception, as it will determine if “progress” has been made.
The periodic evaluations may influence modifications to programming and/or communication mode recommendations
Great news! We already obtain data as part of our routine clinical protocols! What is important, is how we use it.
word recognition
phoneme recognition
sentence testing
background noise
Etc.

5. Four Levels of Auditory Skills
Detection Discrimination Identification Comprehension

6. Detection The ability to respond to presence and absence of sound
In response to sound, a child may:
Turn head
Cease activity
Startle
In therapy, what types of sounds can we use to determine a child’s detection level?
Environmental sounds
Speech sounds
Music
How can we elicit detection?
“I hear that!”
Visual – pointing to ear
Hand over hand, modeling, etc.

7. Discrimination
The ability to perceive differences in suprasegmental features or in the acoustic properties of speech sounds
This level can be particularly helpful in determining if there is a “speech” or an “auditory” problem
Same vs. Different
“ahhh” vs. “ahhh ahhh ahhh” – duration
“oooo” vs. “eeee” – pitch
“AHHHH” vs. “ahhh” - intensity

8. Identification
The ability to reproduce a speech stimulus by naming or identifying by pointing to a picture or repeating what was heard
Example:
Early Speech Perception Test – Low Verbal, Pattern Perception Subtest:
Ball, baby, hotdog, icecream cone
More than just same or different discrimination. This task involves auditory skills, pragmatic skills (taking turns), joint attention
*What you will often see with pediatric patients is imaginary play with the objects! This is a good thing! You want to see this. Why?

9. Comprehension
The ability to understand the meaning of what has been heard

10. Auditory Development: A More Detailed Perspective
Auditory Detection or Attention
Auditory Discrimination
Auditory Self-Monitoring or Feedback
Auditory Identification or Association
Auditory Memory
Auditory Sequencing
Auditory Processing
Auditory Understanding
Auditory Detection or Attention – presence or absence of sound
Auditory Discrimination – perceives differences in sounds
Auditory self-monitoring or Feedback – modify speech to match what was heard
Auditory Identification or Association – label what was heard
Auditory Memory – remember what was heard
Auditory Sequencing – remember what was heard, in correct order
Auditory Processing – make cognitive judgments about what was heard
Auditory Understanding – Comprehend auditory information in a variety of settings
Nancy S. Caleffe-Shenck, M.Ed., C.E.D., CCC-A, Cert. AVT (Adapted from Doreen Pollack, 1985)

11. Acoustic Basis and Description
Ling 6-7 Sound Test
Purpose – to assess a patient’s ability to detect or identify speech sounds across the frequency range.
Sounds – ah, oo, ee, mm, s, sh, and silence
The sounds are chosen based on the frequencies they represent. They cover the low, mid, and high frequency sounds which are important for speech perception.
We want to first know if they can detect all sounds with their given amplification. Then we want to increase the complexity of the task, in order to determine if the child can perceive the sound as it was produced. Detection does not equal perception. We then ask for the patient to repeat the sound back -> identification. BE CAREFUL HOW YOU RECORD THIS!
Not just for pediatric patients, we have many adult patients that are only at the detection stages of this task, and have not be able to progress to discrimination or identification.
We use this information to modify hearing aid programming, we change maps for cochlear implant patients, and we also use it as a starting out point for where to recommend aural habilitation.
There are three recommended distances for the Ling 6 sound test – 1 foot, 3 feet, six feet, nine feet, and 12 feet intervals. This is done to determine the patient’s listening range with their given amplification.
Why do we care about listening range??? It will help us in counseling, and also give us recommendations to make when practicing at home.
Acoustic Basis and Description

12. Purpose Developed first by Daniel Ling
Quick and easy way to verify that a child detects the vowel and consonant sounds of spoken language.
Allows parents, professionals, and teachers to know the child’s distance hearing.
Also allows for device troubleshooting and verification of function.
Children with hearing loss and Ling book

13. Use of Ling 6-7: Levels of Auditory Skills
Can be utilized for all of the four main levels:
Detection
Discrimination
Identification
Comprehension

14. Sound Selection /m/ corresponds to 250 Hz, +/- ½ octave
/u/ is like a narrowband of noise corresponding to 500 Hz on the audiogram, +/- ½ octave
/a/ corresponds to 1000 Hz, +/- ½ octave
“sh” is a band of noise corresponding to 2000 Hz, +/- ½ octave
/s/ is a band of noise corresponding to 4000 Hz, +/- ½ octave
/i/ has a first formant (resonance of the vocal tract) around 500 Hz, and a second formant around 2000 Hz; the second formant must be heard in order for the listener to be able to distinguish between front and back vowels
The silent interval is really a seventh “sound” that is necessary to track false positive responses. Other reasons for using the silent interval?

15. Applications & Instructions for the Ling 6-7 Sound Test
Conditioning
Hand-over-hand facilitation
Modeling
Occupying attention with “quiet” toys
Eliminate visual cues

16. Speech Information & Key Frequencies
250 Hz
500 Hz
1000 Hz
2000 Hz
4000 Hz
First formant of vowels /u/ and /i/
First formants of most vowels
Acoustic cues for manner of articulation
Acoustic cues for place of articulation
The key frequency for /s/ and /z/ audibility is critical for language learning:
-plurals
-idioms
-possessives
-auxiliaries
-third person singular verb forms
-questions
-copulas
-past perfect
Fundamental frequency of female and children
Harmonics of all voices (male, female, child)
Second formants of back and central vowels
Key frequency for speech intelligibility
Nasal murmur /m/, /n/, and /ng/
Voicing cues
C-V and V-C transition information
2nd and 3rd formant information for front vowels
prosody
Nasality cues
Some plosive bursts
Consonant quality
Suprasegmental patterns (stress, rate, inflection, intonation)
Suprasegmentals
Acoustic information for liquids /l/ and /r/
Male voice harmonics
Some plosive bursts associated with /b/ & /d/
Plosive bursts
Voicing Cues
Unstressed morphemes
Affricate bursts
Fricative turbulence
Ling, D. (2002). Speech and the hearing-impaired child: Theory and practice. (2nd ed.). Washington, DC: Alexander Graham Bell Association for the Deaf and Hard of Hearing.

17. Audibility vs. Intelligibility
Audibility = simple act of detection
Ling 6 (or 7) sound test
Environmental sounds
Etc.
Intelligibility = the individual must be able to discriminate the word-sound distinctions of individual phonemes or speech sounds
For speech to be heard clearly, both vowels and consonants must be available acoustically
Can speech be audible but not consistently intelligible?
Yes. Even for a child with a minimal hearing loss.
Children with hearing loss

18. Speech Banana Other lovely names!
Speech pickle
Speech hotdog
Speech boomerang
Audiogram of familiar sounds including speech
Represents concentrations of acoustic energy
i.e., speech frequencies
Limitations of the audiogram?
Based on thresholds for tones or narrowband noise
Cannot truly show a child’s auditory learning experience or potential
Food for thought…
If I can’t “sort by audiogram,” how do I know if a child has potential to do well in developing spoken language through listening?
I'm a Speech Banana!   The Speech Banana was devised by Dr. Daniel Ling as a "catchy" means to describe the frequency and intensity of normal conversational speech as plotted on an audiogram.  Technically, the speech banana on the audiogram represents the loudness of speech when the speaker is at a distance of 2 meters (about 6 feet) from the listener. The 6dB Rule applies here: As distance between the speaker and the listener increases, loudness decreases, and vice versa.  When the distance doubles, loudness decreases by approximately 6 dB HL. Conversely, when the distance is halved, loudness increases by about 6 dB HL. 
First Years

20. Formants Formants are concentrations of acoustic energy
The brain identifies these patterns as specific vowels and consonants
Formants are used by our brain to identify all the sounds of speech
Each phoneme has distinctive patterns of formants
Formants are visual representations of acoustic information contained in speech

21. Acoustic Features of Speech
Suprasegmentals (DIP)
Duration
Intensity
Pitch
Suprasegmentals are responsible for vocal quality.
Think: rhythm, stress, intonation
Acoustic building blocks of speech
Segmentals
Consonants
Vowels

22. Suprasegmentals: Duration
Time
Length of the sound and how it starts, changes, and finishes
Vowels are typically longer than consonants

23. Suprasegmentals: Intensity
Volume
Force or power of the sound
Units are express in decibels
Stress patterns

24. Suprasegmentals: Pitch
Frequency
Measured in Hz
Number of waves created by the vibration from a sound which reach the ear each second

25. Fundamental Frequency
Rate at which the vocal folds vibrate
The rate varies depending on whether the speaker is a:
Male 125 Hz
Woman 250 Hz
Child 325 Hz
Why is this information important?
Who can they hear?
Why it is more difficult for them to hear one person or another?
Expectations and counseling

27. Application Activity #1
Use the Interpretation of Acoustics of Speech
Determine suprasegmental information available to a child with aided hearing out to 500 Hz, and out to 1000 Hz.

28. “Most hearing impaired child, when provided with appropriate hearing aids and sufficient auditory experience can hear enough of the speech signal to acquire natural-sounding, well-inflected voices, because sufficient auditory cues on prosody occur in the frequency range below 1000 Hz (Ling, 1989).”

29. Segmentals
Vowels
Consonants

30. Segmentals: Vowels
Produced by changing the resonance of airflow through the oral cavity by altering the position of the tongue and lips
Tense/lax
Tongue height
Tongue placement
Lip rounding
F1 is important for detection
F2 is important for identification

32. Segmentals: Vowels Reference Vowels?
/a/ = mid frequency/mid tongue
1st formant = 800Hz
2nd formant = 1000Hz
/u/ = low frequency/back of tongue
1st formant = 300 Hz
2nd formant = 900Hz
/i/ = high frequency/front of tongue
2nd formant = 3000 Hz
Notice that they are all in the Ling 6 sound test
What is the significance of knowing the values of these vowels?
If able to detect all three of reference vowels, they should be able to detect ALL vowels out to 3000 Hz.
If able to identify all three of the reference vowels, they should be able to identify all vowels out to 3000 Hz.

33. Speech Acoustics: Vowels

34. Application Activity #2
Use the Interpretation of Speech Acoustics
If I say /u/, and the child responds with “uh,” what do I know?
If I say /i/, and the child responds with /u/, what do I know?
1st formant

36. Vowel Formants
Memorize this sentence for quick recall of the order of the vowels and formants from low frequency to high frequency.
Who would know ought of art must again learn and then take his ease.
What other way can this graph help you?
When you are starting to work on discrimination activities, you want to target vowels at the extremes, to ensure the difference will be readily heard.
Then you can start to work in to where the vowels become more similar in acoustics.

37. Application Activity #3
A child has aided hearing out to 500Hz.
What vowel information is available?
Now try again:
Aided hearing out to 1000 Hz
Aided hearing out to 2000 Hz

38. Application Activity #4
CA: 13 months, HA: 4 months
Aided in the speech banana out to 1500 Hz
Vocal behaviors: squeals, blows raspberries, produces long sustained /m/, produces /a/ and “uh” with long an short duration, beginning to vary pitch in vocal play
What vowel information is available?
Are F1 and F2 of early developmental consonants available?

39. Segmentals: Consonants
Produced by restricting or interrupting airflow along the vocal tract
Manner
Place
Voicing
Important formant(s)?
Depends on the consonant produced

40. Segmentals: Consonants
Place of Production:
Labial
Labiodental
Dental
Alveolar
Palatal
Velar
Glottal
Manner of Production:
Plosive/stop
Fricative
Nasal
Affricate
Liquids/glides
Voicing Component:
Voiced
Unvoiced

41. Speech Acoustics: Consonants

42. Vowels Consonants Strong low-frequency energy
Weak high-frequency sounds
Energy focused at 2000 and 4000 Hz and above
Carry 10% of the energy of speech
BUT…90% of the information needed to perceive the differences among sounds
Strong low-frequency energy
Energy focused at ~250 to 500Hz
Most powerful sounds in English
Carry 90% of the energy of speech
Children with hearing loss

43. (Talking Child, LLC, 2003)
(Talking Child, LLC, 2003)

44.
(Talking Child, LLC, 2003)

45. Special Considerations
Co-articulation
Distance
Noise

46. Co-articulation Co-articulation
Affects consonants of highly consistent ways
Example:
Consonants produced at the front of the mouth will lower formants of preceding vowels (pg. 41, Ling – foundations of spoken language)
Provides listeners with predictable ways to identify; as well as to produce normal speech patterns
How could this help us with a child with high frequency hearing loss?
If we are targeting /s/, and we want to make it more acoustically salient, we can pair /s/ with /u/ in order to bring down the high frequency of /s/ to perhaps make it more audible for the patient.

47. Distance and Noise
What is the most optimal distance for introducing a new target for any of the four levels?
6 inches away from microphone
Why???
6 dB rule, the further you are from the sound source, the softer it will be to the child.
Noise
Children with hearing loss need 20 to 25 dB or better S/N ratio
Check consistently for noise in equipment
How can we use noise to challenge listening skills?
Tape recorded information
Practice using the telephone

49. ALG Goal is to make more than a year’s progress in a year’s time.
Why?
So if a child was two years behind, we would want them to get through the first year of the ALG, and be started on the second year of the ALG in just the first year of audiologic rehabilitation.
Years are outlined by color
Remember back to the chart of Auditory Development
We want to work on specific receptive and expressive skills associated to:
Sound Awareness
Phonemes
Discourse
Sentence
Words